米氮平与帕罗西汀治疗酒依赖患者伴有焦虑抑郁障碍对照研究

Comparison on therapeutic effects of Mirtazapine and Paroxetine in treating alcoholic with anxiety and depression disorder

目的比较米氮平与帕罗西汀治疗酒依赖患者焦虑抑郁障碍的疗效、安全性和复饮率。方法将59例酒依赖伴有抑郁障碍患者随机分为米氮平组(n=29)和帕罗西汀组(n=30),治疗时间为6周,以汉密顿抑郁量表(HAMD)及汉密顿焦虑量表(HAMA)评估临床疗效,1年内每月一次调查复饮情况。用药物不良反应量表(TESS)评估不良反应发生率。采用SPSS 17.0软件包对数据进行分析,率的比较采用χ2检验,P<0.05为差异有统计学意义。结果米氮平组有效率为72.41%,帕罗西汀组有效率为73.33%,组间比较差异无统计学意义。两组1年内复饮率调查米氮平组为34.48%,帕罗西汀组为43.33%,组间比较差异有统计学意义(χ2=6.604,P<0.05)。TESS评估不良反应发生率米氮平组为33.41%,帕罗西汀组为34.09%,组间比较差异无统计学意义(χ2=0.061,P>0.05),但失眠、性功能障碍、胃肠道反应发生率比较,帕罗西汀组明显高于米氮平组,差异有统计学意义(χ2=6.548,P<0.05)。结论米氮平与帕罗西汀治疗酒依赖患者焦虑抑郁障碍疗效相当,但1年内复饮率米氮平组低于帕罗西汀组。

Objective To compare the therapeutic effects and safety of Mirtazapine and Paroxetine in treating alcoholic with anxiety and depression disorder. Methods Fifty-nine alcoholics with anxiety and depression disorder were randomly divided into Mirtazapine group （n= 29） and Paroxetine group （1~= 30） and were trea- ted for 6 weeks. Hamilton Depression Rating Scale-17 （HAMD-17） and Hamilton Anxiety Rating Scale （HA- MA） were used to evaluate the therapeutic effects of the drugs. A follow up survey was conducted once a month for a year. All subjects were followed up. Treatment Emergent Symptom Scale （TESS） was used for the evaluation of side effects. SPSS 17.0 software was applied for data analysis. Results The effective rates of Mirtazapine and Paroxetine were 72.41 % and 73.33 %, respectively. The difference was not statistically significant. 34.48% of patients treated with Mirtazapine started drinking again in one year follow up period, while a higher percentage of 43.33% was found in patients treated with Paroxetine （x^22 ： 6. 604, P〈0.05）. TESS showed that the overall incidence of side effects of these two drugs were close, but more patients experienced insomnia, sexual dysfunction and gastrointestinal illness when treated with Paroxetine （x^2 6. 548, P 0.05）. Conclusions The therapeutic effect of Mirtazapine is similar to that of Paroxetine in treating alcohol ies with anxiety and depression disorder. However, patients are more likely to drink again when treated with Paroxetine.